Streamlined Claim Submission, Accelerated Revenue Generation, Significantly Reduced A/R.

MediDecoder quickly took over managing all patient telephone inquiries, streamlining statement processing through the company's call center. They also initiated training to improve front desk managers' policies and procedures for smoother operations.

The team introduced a designated personal injury and workers' compensation specialist who negotiates with insurance companies for out-of-network payments that do not meet the payment threshold. This specialist negotiates with insurance companies to file claims, enabling the facility to transition from in-network to out-of-network payers for higher reimbursement rates.
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Solution

MediDecoder quickly took over managing all patient telephone inquiries, streamlining statement processing through the company's call center. They also initiated training to improve front desk managers' policies and procedures for smoother operations.

The team introduced a designated personal injury and workers' compensation specialist who negotiates with insurance companies for out-of-network payments that do not meet the payment threshold. This specialist negotiates with insurance companies to file claims, enabling the facility to transition from in-network to out-of-network payers for higher reimbursement rates.

Results

MediDecoder's new quality measures now allow the team to process claims more efficiently for faster reimbursement. Routine audits provide opportunities to review denials and resubmit clean claims, ensuring lower A/R and higher revenue for the facility.

Over the last six months, the orthopedic facility has experienced a $10 million decrease in A/R, 697 fewer phone inquiries, and a 77.47% increase in revenue. The facility now generates approximately $2-2.5 million in revenue each month. Both parties are excited to see where their partnership goes next.

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